Biopsy marker

ABSTRACT

A biopsy marker may include three shaped portions arranged sequentially along an axis, each shaped portion having a first surface and a second surface parallel to the first surface. A first narrow portion connects a first of the three shaped portions to a second of the three shaped portions. A second narrow portion connects the second of the three shaped portions to a third of the three shaped portions. The first narrow portion is twisted about the axis such that the first surface of the first shaped portion is at a first angle to the first surface of the second shaped portion. The second narrow portion is twisted about the axis such that the first surface of the second shaped portion is at a second angle to the first surface of the third shaped portion.

PRIORITY

This application is a continuation of International Application Number PCT/US2015/054679 filed Oct. 8, 2015, which claims priority to U.S. Provisional Application No. 62/061,586 titled “BIOPSY MARKER” filed Oct. 8, 2014, both of which are assigned to the assignee of the current application and hereby incorporated herein by reference in their entirety.

BACKGROUND

The disclosure relates to biopsy markers for marking the site of a biopsy. In particular, the disclosure relates to biopsy markers for use in breast biopsy.

SUMMARY

The following presents a simplified summary of one or more aspects in order to provide a basic understanding of such aspects. This summary is not an extensive overview of all contemplated aspects, and is intended to neither identify key or critical elements of all aspects nor delineate the scope of any or all aspects. Its sole purpose is to present some concepts of one or more aspects in a simplified form as a prelude to the more detailed description that is presented later.

The disclosure provides a biopsy marker. The biopsy marker may include three shaped portions arranged sequentially along an axis, each shaped portion having a first surface and a second surface parallel to the first surface. A first narrow portion may connect a first of the three shaped portions to a second of the three shaped portions. A second narrow portion may connect the second of the three shaped portions to a third of the three shaped portions. The first narrow portion is twisted about the axis such that the first surface of the first shaped portion is at a first angle to the first surface of the second shaped portion. The second narrow portion is twisted about the axis such that the first surface of the second shaped portion is at a second angle to the first surface of the third shaped portion.

The one or more aspects comprise the features hereinafter fully described and particularly pointed out in the claims. The following description and the annexed drawings set forth in detail certain illustrative features of the one or more aspects. These features are indicative, however, of but a few of the various ways in which the principles of various aspects may be employed, and this description is intended to include all such aspects and their equivalents.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed aspects will hereinafter be described in conjunction with the appended drawings, provided to illustrate and not to limit the disclosed aspects, wherein like designations denote like elements, and in which:

FIG. 1 is a plan view of a flat biopsy marker.

FIG. 2A is a plan view of a twisted biopsy marker.

FIG. 2B is an end view of the twisted biopsy marker of FIG. 2A.

FIG. 3 is a plan view of another flat biopsy marker.

FIG. 4A is a plan view of a twisted biopsy marker.

FIG. 4B is an end view of the twisted biopsy marker of FIG. 4A.

FIGS. 5A and 5B illustrate a representation of the twisted biopsy marker of FIG. 2A under magnetic resonance imaging.

FIGS. 6-18 illustrate various shapes of biopsy markers.

FIG. 19 illustrates a biopsy marker within a capsule.

FIGS. 20-22 illustrate a marker and pre-bent push-rod for deploying a marker.

FIG. 23-26 illustrate another marker attached to a pre-bent wire deployer.

FIGS. 27-30 illustrate an elongated bioabsorbable marker.

FIGS. 31-32 illustrate a ball shaped marker with tassles.

FIG. 33 illustrates a whisk shaped marker.

FIG. 34 illustrates a shape for a bioabsorbable material surrounding a marker.

FIGS. 35-37 illustrate a mesh marker.

FIGS. 38 and 39 illustrate a helical marker.

FIGS. 40 and 41 illustrate a coil marker.

FIG. 42 illustrates a plastic marker with bubbles.

FIG. 43 illustrates a spherical spring marker.

FIGS. 44 and 45 illustrate a crimped marker deployer.

FIGS. 46A and 46B illustrate a flat marker having two shaped portions and a narrow portion.

FIGS. 47A and 47B illustrate a twisted marker having two shaped portions and a narrow portion.

FIGS. 48A and 48B illustrate a flat marker having through holes.

FIGS. 49A and 49B illustrate a flat marker having three through holes.

FIGS. 50A and 50B illustrate a twisted marker without a narrow portion.

FIGS. 51A and 51B illustrate a flat marker having two shaped portions and a narrow portion.

FIGS. 52A and 52B illustrate a flat marker having two shaped portions and a narrow portion.

FIGS. 53A-E illustrate various views of a twisted marker having three rectangular shaped portions and two narrow portions.

FIGS. 54A-E illustrate various views of a twisted marker having three rectangular shaped portions and two narrow portions.

FIGS. 55A-E illustrate various views of a twisted marker having two differently shaped portions and an elongated narrow portion.

FIGS. 56A-E illustrate various views of a twisted marker without through holes.

FIGS. 57A-E illustrate various views of a twisted marker having three shaped portions and two twisted portions.

FIGS. 58A-C illustrate various views of a twisted marker having three shaped portions and two twisted portions.

FIGS. 59A-D illustrate various views of another marker.

DETAILED DESCRIPTION

Various aspects are now described with reference to the drawings. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of one or more aspects. It may be evident, however, that such aspects may be practiced without these specific details.

FIG. 1 is a plan view of a flat biopsy marker 10. The flat biopsy marker 10 may include three shaped portions 12 a, 12 b, 12 c. As illustrated, the shaped portions 12 a, 12 b, 12 c are generally circular shaped. However, it should be appreciated that the shaped portions 12 a, 12 b, 12 c may be triangular, rectangular, ellipsoidal, or any other polygonal or curved shapes. In an aspect, the shaped portions 12 a, 12 b, 12 c, may have rounded corners. The shaped portions 12 a and 12 b may be connected by a narrow portion 14 a, and the shaped portions 12 b and 12 c may be connected by a narrow portion 14 b. The shaped portions 12 a, 12 b, 12 c, may be relatively large compared to the narrow portions 14 a, 14 b. In an aspect, each shaped portion 12 a, 12 b, 12 c may include a respective through hole 16 a, 16 b, 16 c. As illustrated, the through holes 16 a, 16 b, 16 c may be generally circular. However, it should be appreciated that the through holes 16 a, 16 b, 16 c may be triangular, rectangular, ellipsoidal, or any other polygonal or curved shapes. Further, some shaped portions may not have a through hole. For example, the marker 10 may include 1, 2, or 3 shaped portions 12 a, 12 b, 12 c including a through hole 16. In an aspect, the length of the flat biopsy marker 10 may be approximately 2.5 mm. The width at a shaped portion 10 may be approximately 0.76 mm. The blank 10 may be approximately 0.1 mm thick.

In an aspect, the flat biopsy marker 10 may be made from a stainless steel, titanium, or other metallic sheet using a stamping process. A die may be used to cut one or more flat biopsy markers 10 from the sheet. The flat biopsy marker 10 may serve as a blank for a twisted biopsy marker.

FIG. 2A is a plan view of a twisted biopsy marker 20. The twisted biopsy marker 20 may be formed from the flat biopsy marker 10 by twisting the flat biopsy marker 10 at the narrow portions 14 a and 14 b about an axis 26. Accordingly, the twisted biopsy marker 20 may include three shaped portions 22 a, 22 b, 22 c corresponding to the shaped portions 12 a, 12 b, 12 c. In an aspect, as illustrated in FIG. 2B, the narrow portion 24 a may be twisted about the axis 26 such that a first angle between a surface of the shaped portion 22 a and a surface of the shaped portion 22 b may be approximately 45 degrees. As used herein, the term “approximately,” when applied to an angle, may allow a range of plus or minus 5 degrees, for example, to account for manufacturing tolerances. The narrow portion may also be twisted to other angles between 0 degrees and 180 degrees. For example, the narrow portion may be twisted to 15 degrees, 30 degrees, 40 degrees, 50 degrees, 60 degrees, 75 degrees, 90 degrees, etc. In an aspect, the narrow portion 24 b may be twisted such that a second angle between the shaped portion 22 b and the shaped portion 22 c may be approximately 45 degrees, or another angle that differentiates the surface of the shaped portion 22 c from the shaped portions 22 a and 22 b. The second angle may be different than the first angle. In an aspect, the total angle between the shaped portion 22 a and the shaped portion 22 c may be approximately 90 degrees. Other angles may also be selected, for example, based on imaging techniques to be used to view the marker 20.

FIG. 3 a plan view of another flat biopsy marker 30. The flat biopsy marker 30 may include three shaped portions 32 a, 32 b, 32 c. As illustrated, the central shaped portion 32 b is generally circular shaped. However, it should be appreciated that the shaped portions 32 b may be triangular, rectangular, ellipsoidal, or any other polygonal or curved shapes. The central shaped portion 32 b may include a through hole 36. As illustrated, the through hole 36 may be generally circular. However, it should be appreciated that the through hole 36 may be triangular, rectangular, ellipsoidal, or any other polygonal or curved shapes. In an aspect, the central shaped portion 32 b may not include a through hole, or may include more than one through hole. The end shaped portions 32 a and 32 c may be an open shape. As illustrated, the end shaped portions 32 a and 32 c may each be an open semi-circle. The end shaped portions 32 a and 32 c may each include a respective cut-out 38 a, 38 b facing the end of the marker blank 30. The shaped portions 32 a and 32 b may be connected by a narrow portion 34 a, and the shaped portions 32 b and 32 c may be connected by a narrow portion 34 b.

FIG. 4A is a plan view of a twisted biopsy marker. The twisted biopsy marker 40 may be formed from the flat biopsy marker 30 by twisting the flat biopsy marker 30 at the narrow portions 34 a and 34 b. Accordingly, the twisted biopsy marker 40 may include three shaped portions 42 a, 42 b, 42 c corresponding to the shaped portions 32 a, 32 b, 32 c. In an aspect, as illustrated in FIG. 4B, the narrow portion 44 a may be twisted such that a first angle between the shaped portion 42 a and the shaped portion 42 b may be approximately 45 degrees. The narrow portion 34 a may be twisted to other angles between 0 degrees and 180 degrees. For example, the narrow portion may be twisted to 15 degrees, 30 degrees, 40 degrees, 50 degrees, 60 degrees, 75 degrees, 90 degrees, etc. In an aspect, the narrow portion 44 b may be twisted such that a second angle between the shaped portion 42 b and the shaped portion 42 c may be approximately 45 degrees, or another angle that differentiates the surface of the shaped portion 42 c from the shaped portions 42 a and 42 b. The total angle between the shaped portion 42 a and the shaped portion 42 c may be approximately 90 degrees. Other angles may also be selected, for example, based on imaging techniques to be used to view the marker. The cut-outs 48 a, 48 b may expose a concave surface when the marker 40 is viewed from an end.

In an aspect, the biopsy marker 20 or biopsy marker 40 may be encapsulated in a bioabsorbable material such a collagen, gelatin, etc. The bioabsorbable material may be compressed. In an aspect, the force used to compress the bioabsorbable material may also exert force on the embedded biopsy marker. In an aspect, the size, shape, and thickness of the biopsy marker 20 or biopsy marker 40 may be selected to withstand forces applied during compression without significant deformation or breakage.

In an aspect, the biopsy marker 20 or biopsy marker 40 may be implanted into soft human or animal tissue during a biopsy procedure. For example, the biopsy marker 20, 40 may be inserted into human breast tissue during a breast biopsy to mark the site of the biopsy. If the biopsy marker 20, 40 is embedded within a bioabsorbable material, the bioabsorbable material may help position the biopsy marker 20, 40 within the center of a biopsy cavity. The biopsy marker 20 may rotate within the animal tissue after insertion. Further, when the tissue is being imaged, the tissue may be compressed causing further rotation. The orientation of the biopsy marker may be unknown prior to imaging. The biopsy marker 20 or biopsy marker 40 may be imaged using various imaging techniques including x-ray (stereo), ultrasound, and magnetic resonance imaging (MRI), among other imaging techniques.

Under x-ray, two or more angles may be used to provide a composite stereo image. For example, breast tissue may generally be imaged from a cranial-to-caudal approach, a medial-to-lateral approach, and from a 45 degree angle between the two previous approaches. The twists of the biopsy markers 20, 40 may help increase visibility of the markers 20, 40 from each imaging approach, in addition to helping to identify the markers 20, 40 as having a shape that is recognizable as artificial when compared to the surrounding tissue. For example, if one of the approaches aligns with the longitudinal axis 26 of the biopsy marker 20, 40, the total surface area of the marker may be increased as a partial surface of each of the shaped portions 22, 42 may be imaged. If the approach is transverse to the longitudinal axis, the surface of at least one of the shaped portions 22, 42 may be imaged.

Under ultrasound, the biopsy markers 20, 40 include various curved and concave surfaces that may provide echogenic features. For example, the through holes 36, 46 may provide echogenic features oriented in different angles. Further, in the biopsy marker 40, the cut-outs 48 may expose a concave surface when the marker 40 is imaged in alignment with the longitudinal axis.

Under MRI, images may be generated using slices in coronal, sagittal, and axial orientations. As discussed above regarding x-ray imaging, the twists of the biopsy markers 20, 40 may provide at least one surface that is visible in each orientation, in addition to helping to identify the markers 20, 40 as having a shape that is recognizable as artificial when compared to the surrounding tissue. Magnetic resonance has further effects based on the material of the marker 20, 40. Metallic materials produce an artifact, that is, an image outside of the physical boundaries of the markers 20, 40. The artifact may also be referred to as a bloom. Generally, the artifact produced by a marker may be a dark spot in an MR image while a lesion or cyst may absorb a contrast agent and produce a relatively bright spot. The artifact produced by a marker may obscure the image of surrounding tissue, making it difficult to determine whether the surrounding tissue includes a lesion or cyst. Some modern MR machines may reduce artifact using advanced image processing techniques. In some cases, such artifact reduction may make it difficult to locate a marker in an image.

FIGS. 5A and 5B illustrate a representation 50 of the twisted biopsy marker 20 under magnetic resonance imaging. Generally, the artifact produced by a marker is roughly proportional to the mass of the marker. Titanium markers generally produce less artifact than stainless steel markers. For example, the line 52 may illustrate an artifact that may be produced by a titanium marker while the line 54 may illustrate an artifact that may be produced by a stainless steel marker having the same dimensions. Physicians may select a marker based on the MR machine most likely to be used for future imaging of the marker. When imaged transverse to the longitudinal axis, as in FIG. 5A, the twisted biopsy marker 20 may produce three distinct lobes. When imaged along the longitudinal axis, as in FIG. 5B, the twisted biopsy marker 20 may produce a generally circular artifact, but two lobes may be distinguishable. The through holes 16 of the marker 20 or the through hole 46 and cutouts 48 of marker 40 may help reduce the artifact produced by the markers 20, 40. For example, the through holes and cutouts may reduce the mass of each shaped portion in comparison to a similar shaped portion without a through hole or cutout. In an aspect, an artifact may extend into the interior of a through hole or cutout while extending less from the exterior edges of the marker 20, 40.

FIGS. 6-18 illustrate various additional shapes and features for markers. These additional shapes or features may be combined with the twisted markers 20, 40 to create markers having desirable imaging properties. Further, markers of different shapes may be used in subsequent procedures to provide a unique marker for each biopsy location.

FIG. 6 illustrates a star shaped marker.

FIG. 7 illustrates a star shaped marker having a through hole.

FIG. 8 illustrates jack shaped markers. A jack shaped marker may be imageable from different approaches or orientations.

FIG. 9 illustrates a concave dish shaped marker. The concave surface of the marker may provide an echogenic surface under ultrasound imaging.

FIG. 10 illustrates a triangle shaped marker.

FIG. 11 illustrates a cone shaped marker. The cone may be bent to lessen a triangular effect.

FIG. 12 illustrates a heart shaped marker.

FIG. 13 illustrates a marker having a distinct shape formed by through holes. For example, the marker may appear as a smiling face. Different shapes may be created by varying the size and shape of the through holes.

FIG. 14 illustrates a marker shaped like a letter. For example, the marker may be shaped like a capital A. Markers in the shape of different letters or having portions shaped like particular letters may help identify a specific marker.

FIG. 15 illustrates a marker shaped like a number. For example, the marker may be in the shape of the number 1. Markers in the shape of different numbers or having portions shaped like particular numbers may help identify a specific marker.

FIG. 16 illustrates a marker shaped as a rectangle with a through slot.

FIG. 17 illustrates a marker shaped as a rectangle with a pattern of through holes.

FIG. 18 illustrates markers shaped as a barbed arrow. The protrusions or barbs of the marker may provide surfaces that may be imaged from different approaches or orientations.

FIG. 19 illustrates a marker contained in a capsule. The capsule may be formed of a bioabsorbable material such a gelatin that may be absorbed over time at the biopsy cavity. The capsule may include a marker such as the markers 20, 40 discussed above embedded in a second bioabsorbable material. During manufacture, the capsule may have non-uniform features to prevent the two halves from separating. Further, the two capsule halves may be wetted with alcohol or a bonding agent to securely adhere the two halves together.

FIG. 20 illustrates a marker and pre-bent push-rod for deploying a marker at a biopsy cavity. The marker may be encapsulated in a bioabsorbable material formed at the end of the pre-bent push-rod. As illustrated in FIG. 21, the marker and pre-bent push rod may be deployed through a biopsy needle. When in the longitudinal cannula of the biopsy needle, the pre-bent push-rod may be straightened. As illustrated in FIG. 22, when the marker reaches the aperture of the biopsy needle, the pre-bent push rod may return to its bent shape and the bioabsorbable material holding the marker may protrude from the biopsy needle. A physician operating the biopsy needle may notice the pre-bent push rod returning to the bent position. The longitudinal movement of the pre-bent push rod may also be prevented when the push-rod returns to the bent configuration. The cutter of the biopsy needle may be used to shear off the tip of the bioabsorbable material including the marker.

FIG. 23 illustrates another marker attached to a pre-bent wire deployer. The pre-bent wire may be partially embedded in the bioabsorbable material encapsulating the marker. As illustrated in FIG. 24, the marker and pre-bent wire may be deployed through a biopsy needle. When in the longitudinal cannula of the biopsy needle, the pre-bent wire may be straightened. As illustrated in FIG. 25, when the marker reaches the aperture of the biopsy needle, the pre-bent wire may return to its bent shape and the bioabsorbable material holding the marker may protrude from the biopsy needle. A physician operating the biopsy needle may notice the pre-bent wire returning to the bent configuration. The longitudinal movement of the pre-bent wire may also be prevented when the push-rod returns to the bent configuration. When the pre-bent wire is pulled proximally, the bioabsorbable material may catch on the edge of the aperture of the biopsy needle or the cutter, or may otherwise prevent the encapsulated marker from retracting with the wire, thus removing the wire from the bioabsorbable material and leaving the marker at the biopsy cavity.

FIG. 27 illustrates an elongated marker formed of a bioabsorbable material such as collagen. One or more permanent metallic or ceramic markers may be embedded in the elongated marker. As illustrated in FIG. 28, the elongated marker may be deployed using a marker deployer. The elongated marker may be bent within the marker deployer. As illustrated in FIG. 29, the marker deployer may be deployed through the cannula of a biopsy needle having a lateral aperture. The elongated marker may be pushed to the distal end of the marker deployer with a push rod. As illustrated in FIG. 30, when the elongated marker is pushed out of the marker deployer, it may straighten. The straightened elongated marker may be unlikely to reenter the aperture of the biopsy needle.

FIG. 31 illustrates a ball shaped marker with tassles. The ball may be made from a bioabsorbable material such as collagen and may include a permanent marker embedded therein. The tassles may be made of a suture material. The ball shaped marker with tassles may be deployed through a marker deployer such that the tassles follow the ball. As illustrated in FIG. 32, once the ball shaped marker with tassles is pushed into the biopsy cavity, the tassles may fan out and help reduce marker migration.

FIG. 33 illustrates a whisk shaped marker. The tines of the marker may be held together during deployment. Once the marker is deployed, the tines may spread out. The tines may help reduce migration of the marker and may also increase an imageable area of the marker.

FIG. 34 illustrates a shape for a bioabsorbable material surrounding a marker. The bioabsorbable material may initially be shaped as a cylinder having one or more X shaped sections along the length. The bioabsorbable material may be compressed to fit within a marker deployer. The bioabsorbable material may expand within the biopsy cavity. The X shaped sections may reduce migration and improve imageability. Compared to a cylinder of bioabsorbable material having the same mass, the bioabsorbable material having X shaped sections may have a greater inscribed volume.

FIG. 35 illustrates a mesh marker inside a deployer. The mesh marker may be deployed using a balloon. As illustrated in FIG. 36, the mesh marker may be deployed past the end of a biopsy needle, and the balloon may be expanded to expand the mesh marker. For example, the mesh marker may be expanded to the size of the biopsy cavity. As illustrated in FIG. 37, the balloon may be deflated and retracted through the biopsy needle, leaving the marker behind.

FIG. 38 illustrates a helical marker. The helical marker may be deployed through the distal end of a biopsy needle. As illustrated in FIG. 39, the helical marker may be deployed by screwing the helical marker into tissue at the end of the biopsy needle. The marker deployer may be threaded such that a push-rod rotates as it travels through the deployer. The helical marker may be firmly fixed within the tissue with little likelihood of migration.

FIG. 40 illustrates a coil marker for deployment through a biopsy needle having a lateral aperture. The coil marker may be a loose spring formed of a material that does not permanently elastically deform when stretched out. For example, the coil marker may be formed of titanium. The coil marker may be straightened for deployment through the longitudinal cannula of a biopsy needle or marker deployer. When the coil marker is deployed into the biopsy cavity, the coil marker may return to the coiled spring configuration as illustrated in FIG. 41.

FIG. 42 illustrates a plastic marker with bubbles. The plastic marker may be molded around a metallic or ceramic marker. When the plastic marker is being molded, air bubbles may be induced into the plastic. Bubbles may also be formed using spheres of glass as a filler. The air bubbles or glass spheres may create a density difference in the marker for ultrasound imaging.

FIG. 43 illustrates a spherical spring marker. The spherical spring marker may be compressed flat and embedded within a bioabsorbable material. The spherical spring marker may be deployed using any of the deployment devices and techniques described herein. The bioabsorbable material may be absorbed at the biopsy cavity and the spherical spring marker may return to a spherical shape.

FIG. 44 illustrates a crimped marker deployer. The crimped marker deployer may include crimps, notches, or points of weakness that predetermine how the marker deployer will deform when compressed longitudinally. For example, the crimped marker deployer may include a notch that holds the marker and two crimps proximal to the marker. As illustrated in FIG. 45, when the crimped marker deployer is pushed against the distal end of the biopsy device, the crimped marker deployer may buckle at the notch and the crimps, causing the marker to extend laterally out of a lateral aperture.

FIGS. 46A and 46B illustrate a flat marker having two shaped portions and a narrow portion. Each shaped portion has a cutout on its exterior side. In an aspect, the marker may be approximately 0.1 inches long, 0.037 inches wide and 0.006 inches thick. The dimensions of the marker may vary based on a material of the marker. For example, the dimensions for a titanium marker may be scaled to be larger than a stainless steel marker.

FIGS. 47A and 47B illustrate a twisted marker having two shaped portions and a narrow portion. Each shaped portion has a D-like shape and includes a through hole shaped like the letter D. In an aspect, the marker may be approximately 0.1 inches long, 0.037 inches wide and 0.007 inches thick.

FIGS. 48A and 48B illustrate a flat marker having through holes. In an aspect, the marker may have an elongated oval shape. Each through hole may be shaped like a wide letter D. The marker may be approximately 0.1 inches long, 0.037 inches wide and 0.007 inches thick.

FIGS. 49A and 49B illustrate a flat marker having three through holes. The marker may be an elongated oval shape approximately 0.16 inches long, 0.37 inches wide and 0.007 inches thick. The through holes may be different shapes such as trapezoids. Bridging portions may connect the elongated sides between through holes. The bridging portions may be slanted or straight.

FIGS. 50A and 50B illustrate a twisted marker without a narrow portion. Instead, the twisted marker may be formed from an elongated oval shaped flat marker. When twisted, the elongated sides of the marker may bend. The marker may be approximately 0.12 inches long, 0.037 inches wide and 0.007 inches thick.

FIGS. 51A and 51B illustrate a flat marker having two shaped portions and a narrow portion. The shaped portions may be wider toward the outside and narrow toward the middle. The shaped portions may include through holes of similar shape. In an aspect, the marker may be approximately 0.1 inches long, 0.026 inches wide and 0.007 inches thick.

FIGS. 52A and 52B illustrate a flat marker having two shaped portions and a narrow portion. Each shaped portion may be elongated and include multiple through holes. In an aspect, the marker may be approximately 0.13 inches long, 0.026 inches wide and 0.007 inches thick.

FIGS. 53A-E illustrate various views of a twisted marker 500 having three shaped portions 502 a-c and two narrow portions 504 a and b. The twisted marker 500 may be similar to the twisted marker 20 (FIG. 2A). Each shaped portion 502 may be shaped as a rounded rectangle. The through holes 504 may also be shaped as rounded rectangles. As illustrated in FIG. 53E, the angle between each of the shaped portions may be approximately 45°. That is, the angle between a surface of shaped portion 502 a and a surface of shaped portion 502 b may be a 45° angle, and the angle between a surface of shaped portion 502 b and a surface of shaped portion 502 c may be a 45° angle. In another aspect, the marker 500 may be twisted such that the angle between each of the shaped portions 502 may be approximately 30°.

FIGS. 54A-E illustrate various views of a twisted marker 510 having three shaped portions 512 and two narrow portions 514. The twisted marker 510 may be similar to the twisted marker 20 (FIG. 2A). Each shaped portion 512 may be shaped as a rounded rectangle. The through holes 514 may be circles. As illustrated in FIG. 54E, the angle between the surfaces of each of the shaped portions may be approximately 60 degrees. That is, the angle between a surface of shaped portion 512 a and a surface of shaped portion 512 b may be a 60 degree angle, and the angle between a surface of shaped portion 512 b and a surface of shaped portion 512 c may be a 60° angle. For a marker having three shaped portions, an angle of 60 degrees may result in each of the flat surfaces being twisted to an equal angle from the other surface. That is, a surface of the shaped portion 512 a may also be at a 60 degree angle to the surface of the shaped portion 512 c. Such an arrangement may present a portion of a surface of a shaped portion from any angle transverse to the axis.

FIGS. 55A-E illustrate various views of a twisted marker having two differently shaped portions and an elongated narrow portion. For example, a first shaped portion may be circular. The first shaped portion may include a through hole. The second shaped portion may be cross or plus-sign shaped. The elongated narrow portion may be twisted. In an aspect, the elongated narrow portion may reduce the stress of twisting and provide strength against breakage, for example, when a bioabsorbable material surrounding the marker is compressed.

FIGS. 56A-E illustrate various views of a twisted marker similar to the marker in FIGS. 55A-E, except the twisted marker does not include a through hole.

FIGS. 57A-E illustrate various views of a twisted marker having three shaped portions and two twisted portions. The shaped portions may have different shapes. For example, as illustrated, the outer shaped portions may be shaped like a cross or plus-sign and the middle shaped portion may be shaped like a heart. The heart shape may be modified to connect to the narrow portions. Each shaped portion may also include through holes (not shown).

FIGS. 58A-C illustrate various views of a twisted marker having three shaped portions and two twisted portions. The outer shaped portions may be similar to those in FIG. 57, that is, shaped like a cross or plus sign. The middle shaped portion may be rectangular. The narrow portions may each be twisted to approximately 60 degrees.

FIGS. 59A-D illustrate various views of a marker. The marker may have a shaped portion, a twisted portion, and a rolled portion. The shaped portion may be any of the shapes discussed herein. As illustrated in FIG. 59A for example, the shaped portion may be rectangular. The shaped portion may include one or more through holes. The rolled portion may be bent or rolled in one or more dimensions. In an aspect, the rolled portion may be formed from a flat shaped portion that is then rolled or bent. For example, as illustrated in FIGS. 59A-D, the rolled portion may be formed from a rectangular flat shaped portion. In an aspect, a marker blank for the marker in FIGS. 59A-D may be initially T shaped, then the top portion of the T may be rolled inward from each side. The rolled portion may also include one or more through holes. As illustrated, for example, in FIG. 59B, a through hole on each side of the rolled portion may align. The two sides of the rolled portion may meet, for example, along a center axis of the marker. The twisted portion may connect the shaped portion and the rolled portion. In an aspect, one or more sub-portions of the twisted portion may be twisted in different directions. For example, a sub-portion on one side of the twisted portion may be twisted in one direction and a sub-portion on the other side of the twisted portion may be twisted in the opposite direction. In an aspect, the marker may include a connecting portion that is not twisted, or the shaped portion may be formed contiguously with the rolled portion.

While the foregoing disclosure discusses illustrative aspects and/or embodiments, it should be noted that various changes and modifications could be made herein without departing from the scope of the described aspects and/or embodiments as defined by the appended claims. Furthermore, although elements of the described aspects and/or embodiments may be described or claimed in the singular, the plural is contemplated unless limitation to the singular is explicitly stated. Additionally, all or a portion of any aspect and/or embodiment may be utilized with all or a portion of any other aspect and/or embodiment, unless stated otherwise. 

What is claimed is:
 1. A biopsy marker comprising: a first shaped portion, a second shaped portion, and a third shaped portion arranged sequentially along an axis, each shaped portion having a first planar surface; wherein the first planar surface of the first shaped portion is arranged at a first selected angle to the first planar surface of the second shaped portion, and the first planar surface of the second shaped portion is arranged at a second selected angle to the first planar surface of the third shaped portion, wherein the first planar surface of the first shaped portion is arranged at a third selected angle to the first planar surface of the third shaped portion.
 2. The biopsy marker of claim 1, wherein the second shaped portion has a through hole extending through the first planar surface.
 3. The biopsy marker of claim 2, wherein the first shaped portion and the second shaped portion each have a through hole extending through the respective first planar surfaces.
 4. The biopsy marker of claim 2, wherein the first shaped portion and the third shaped portion each have a cutout along an outer edge.
 5. The biopsy marker of claim 2, wherein each of the three shaped portions has a rectangular shape.
 6. The biopsy marker of claim 2, wherein the through hole has a circular cross-section.
 7. The biopsy marker of claim 1, wherein the first selected angle and the second selected angle are each approximately 30 degrees.
 8. The biopsy marker of claim 1, further comprising a bioabsorbable material surrounding the first shaped portion, the second shaped portion, and the third shaped portion.
 9. The biopsy marker of claim 8, wherein the bioabsorbable material is compressed.
 10. The biopsy marker of claim 1, further comprising: a first narrow twisted portion connecting the first shaped portion to the second shaped portion; and a second narrow twisted portion connecting the second shaped portion to the third shaped portion.
 11. A biopsy marker comprising: three shaped portions arranged sequentially along an axis, each shaped portion having a first planar surface and a second planar surface parallel to the first planar surface; a first narrow portion connecting a first of the three shaped portions to a second of the three shaped portions; and a second narrow portion connecting the second of the three shaped portions to a third of the three shaped portions, wherein the first narrow portion is twisted about the axis such that the first planar surface of the first shaped portion is arranged at a first angle to the first planar surface of the second shaped portion, wherein the second narrow portion is twisted about the axis such that the first planar surface of the second shaped portion is arranged at a second angle to the first planar surface of the third shaped portion.
 12. The biopsy marker of claim 11, wherein the second shaped portion has a through hole extending between the first planar surface and the second planar surface.
 13. The biopsy marker of claim 12, wherein the first shaped portion and the second shaped portion each have a through hole extending between the respective first planar surface and second planar surface.
 14. The biopsy marker of claim 12, wherein the first shaped portion and the third shaped portion each have a cutout along an outer edge, the cutout extending between the first planar surface and the second planar surface.
 15. The biopsy marker of claim 12, wherein each of the three shaped portions has a rectangular shape.
 16. The biopsy marker of claim 12, wherein the through hole has a circular cross-section.
 17. The biopsy marker of claim 11, wherein the first angle and the second angle are each approximately 60 degrees.
 18. The biopsy marker of claim 11, further comprising a bioabsorbable material surrounding the three shaped portions, the first narrow portion, and the second narrow portion.
 19. The biopsy marker of claim 18, wherein the bioabsorbable material is compressed. 